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dc.contributor.authorOliveira, M.pt_PT
dc.contributor.authorFidalgo, M.pt_PT
dc.contributor.authorFontão, L.pt_PT
dc.contributor.authorAntão, J.pt_PT
dc.contributor.authorMarques, S.pt_PT
dc.contributor.authorAfreixo, V.pt_PT
dc.contributor.authorGregório, T.pt_PT
dc.description.abstractIntroduction Alteplase is an approved treatment for acute ischemic stroke. Tenecteplase is a genetically modified form of alteplase, with lower cost and a more favourable pharmacokinetic profile allowing bolus injection. The aim of this study was to compare both drugs in adult patients with acute ischemic stroke undergoing thrombolysis. Material and methods PubMed and CENTRAL were searched for observational and experimental studies comparing both drugs in the population of interest. Additional studies were sought in clinical trial registries and by means of reference check. The efficacy outcomes of interest were functional status at 3 months, recanalization and early neurological improvement (ENI). The safety outcomes of interest were cerebral haemorrhage (ICH), symptomatic ICH and mortality. The effect measure of interest was the absolute risk difference (ARD). Effect measures for each outcome were pooled across studies using random effect models. Results Eight studies were included, involving 2031 patients. Overall, there were no differences in terms of good or excellent functional outcome (ARR = 0.07 and 0.03 respectively, p > 0.05 for both comparisons) but tenecteplase patients showed higher rates of recanalization (ARD = 0.11, 95% CI [0.01;0.20]) and ENI (ARD = 0.10, 95% CI [0.02;0.17]). There were no differences between groups in terms of ICH (ARD = -0.02, 95% CI [−0.06;0.01]), symptomatic ICH (ARD = 0.00, 95% CI [−0.01;0.02]) or death (ARD = 0.00, 95% CI [−0.03;0.03]). Conclusion Tenecteplase is an alternative to alteplase for stroke thrombolysis, with lower cost and a more favourable pharmacokinetic profile.pt_PT
dc.subjectCerebral hemorrhagept_PT
dc.subjectFibrinolytic agentspt_PT
dc.subjectThrombolytic therapypt_PT
dc.subjectThrombotic strokept_PT
dc.subjectTissue plasminogen activatorpt_PT
dc.titleTenecteplase for thrombolysis in stroke patients: systematic review with meta-analysispt_PT
degois.publication.titleThe American Journal of Emergency Medicinept_PT
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